New data presented at ESMO show AstraZeneca and Daiichi Sankyo’s antibody-drug conjugate Enhertu produced strong benefit when moved into earlier-stage HER2-positive breast cancer, prompting companies and clinicians to consider curative applications beyond metastatic settings. Trial readouts reported higher rates of pathologic response when the ADC was administered before surgery, a step-change from its established role in advanced disease. Separately, AstraZeneca showcased early clinical results for its in-house ADC platform at the same meeting, reinforcing the company’s strategy to invest in proprietary linker-payload chemistry. Those presentations underline a broader shift at ESMO: ADCs are advancing toward earlier lines of therapy and adjuvant settings, challenging traditional chemotherapy paradigms and reshaping development priorities for partners and competitors. Clinical discussants at ESMO highlighted tolerability signals and the need for longer follow-up to confirm survival outcomes, while regulators and payers will watch whether early-stage gains translate to durable cures.